Current Topics in Global Health: Zika Virus (Part II)

Part I of our current topics post on Zika virus examined the origin and spread of Zika virus, as well as its potential link to microcephaly and GBS. The timing seems to make sense, but WHO estimates it could take four to six months to determine whether these associations are causal. The virus has been found in the tissues of several infants who died from microcephaly, and efforts are underway to study mothers who have reported symptoms, or had a confirmed case, of the virus during their pregnancies [1].

Between January 1 2007 and February 17 2016, a total of 48 countries and territories reported local transmission of Zika virus. This includes countries where the outbreak has been deemed over, with the latest cases reported in Aruba and Bonaire [2]. The Public Health Agency of Canada (PHAC) has confirmed travel-related cases of Zika virus from Central and South America, and from the Caribbean. However, the Aedes mosquito vector is not present in Canada due to our climate. Although the overall risk to travellers is low, PHAC advises pregnant women or those considering becoming pregnant to consider postponing travel to these regions. If postponing is not an option, PHAC recommends these groups take all possible measures to prevent being bitten by mosquitos [3]. These measures include wearing long sleeves and long pants, using insecticide-treated mosquito nets (especially if sleeping during the day when the Aedes mosquito is most active), and using insect repellents. It has also been recommended that men with a pregnant partner who reside in, or have travelled to, these areas use condoms consistently and correctly [4]. Eliminating possible mosquito breeding sites is also recommended, such as areas where rain collects, and where water is stored outside [5].

It is likely that once a person has been infected with Zika virus, they will be protected from future infections. There is no specific medicine to treat, or vaccine to prevent Zika virus. Symptoms are treated with rest, drinking plenty of fluids to prevent dehydration and taking mild pain and fever relief medicine (i.e. acetaminophen). It is recommended that those with Zika virus also take extra measures to prevent being bitten by mosquitos during the first week of infection, in order to halt further transmission [6].

Zika virus has prompted international discussions around disability and reproductive rights. El Salvador has recommended that women do not get pregnant until 2018 [7]. The Pope has suggested that artificial contraception may be morally acceptable in the fight against the Zika virus and its associated microcephaly. Abortion laws are being re-examined in Brazil and other Latin American countries where Zika virus is prominent [8]. Various disability rights groups are lobbying for increased support for women who have babies with microcephaly [9]. Further concerns have been raised as the 2016 Summer Olympics are set to kick off in Rio de Janeiro on August 5. One of the biggest sporting events in the world, the Olympics sure to draw travellers for all over the globe. Brazilian officials are dramatically increasing mosquito eradication efforts, but what impact will Zika have on this gathering of nations [6]?

One thing is certain: the Zika virus is going to be a global health issue to watch in 2016.